| NPI | 1265783922 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: KS RBT-23-295075) |
| Additional Taxonomies | 225A00000X Music Therapist |
| Enumeration Date | 2012-09-21 |
| Last Update Date | 2023-09-05 |